A 64-year-old man was admitted urgently for pain and abdominal discomfort after accidental fall from a left flank injury.
At all times, the patient remains stable and conscious, but reports increasing abdominal pain.
The only personal history was hypercholesterolemia that treated with a medication that did not remember.
On physical examination, the abdomen is distended and defends authentication.
Urgent blood and urine tests, coagulation tests and computerized axial tomography of the abdomen and pelvis were requested.
Urine analysis showed mild microhematuria.
The hemoglobin level was 13.1 g/dl, coagulation was normal, creatinine level was normal 1.2 mg/dl, normal, and amylase 223 U/L. The rest of the laboratory tests were normal.
The CT scan identified a normal right kidney and a left kidney about 35 cm in size with an atrophic parenchyma distorted in some areas due to active bleeding.
A large amount of fluid from the left retroperitoneum can be observed in the peritoneal cavity, crossing in front of the aorta.
It was decided to perform an urgent exploratory laparotomy, identifying during it an opening in the parietal peritoneum in the left paraaortic region where a hemourinous fluid flows.
A large hydronephrotic and atrophic kidney was found in the retroperitoneum with ureteropyelocaliectasia until the pelvic ureter was removed.
During the postoperative period, the patient has a fever peak of 38oC that remits after starting respiratory physiotherapy.
Subsequently, the patient is asymptomatic and discharged with normal renal function.
